Abstract
Purpose: :
To investigate the effect of residential blind rehabilitation on patients’ vision targeted health related quality of life (HRQOL) and general physical and mental function over a period of several years.
Methods: :
206 legally blind veterans were administered the National Eye Institute Visual Function Questionnaire (NEI-VFQ) 25-item version plus appendix, the SF-12 and a mental status questionnaire in a telephone interview prior to their entering a residential (in-patient) blind rehabilitation program. These questionnaires were administered again to 185, 176, 107 and 117 subjects at 2, 6, 18 and 30 months after completion of the rehabilitation program, respectively.
Results: :
At 2 and 6 months post rehabilitation there was an improvement in 9 of 11 NEI-VFQ subscales scores (driving omitted). The largest increases were for the near and distance vision subscales which at 6 months were 30 and 13 points above baseline, respectively. There was also an improvement in the SF-12 mental component summary although the physical component declined. At 18 and 30 months there was continued decline in physical health although cognitive function remained high. NEI-VFQ scores for near vision, general vision, mental health and role difficulty remained significantly higher than pre-rehabilitation scores (p < 0.05). At 18 and 30 months the near vision score, although reduced, remained over 20 points higher than at baseline (p <0.05). In contrast, there was an erosion of the gains seen at 2 and 6 months for other subscales such that scores were no longer significantly higher than baseline at 18 months (color vision, social function, and dependency) or 30 months (distance vision). Ocular pain and peripheral vision were not affected by rehabilitation.
Conclusions: :
Vision rehabilitation had positive, short-term effects on nearly all aspects of vision targeted HRQOL assessed by the NEI-VFQ. It also had positive effects lasting more than 2 years on general vision, near vision, mental health and role difficulty. Post-rehabilitation booster programs focused on areas where function declines significantly after several years might be considered.